Kierney Elizabeth Jackson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7782 Issued in GA

Practice address

200 S Enota Dr NE Ste 360
Gainesville, GA 30501-3466

Phone

(770) 219-4000

NPI assigned

Mar 11, 2009

Last updated

Sep 25, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of Alabama School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northeast Georgia Physicians Group IncGroup PAC ID 6901898386, 884 clinicians

University Surgical Associates of AthensGroup PAC ID 2668463290, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029

Merit-based Incentive Payment System (MIPS)

Final score

92.37 of 100Reported as group

Quality

88.37

Promoting interoperability

100

Improvement activities

40

Cost

70.95

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northeast Georgia Physicians Group Inc

  • Family Medicine Physician
  • Gainesville, GA
  • NPI 1891745212

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• University Surgical Associates of Athens

  dba University Vascular

  • Specialist
  • Watkinsville, GA
  • NPI 1861500183
  Medicare reassignment Care Compare group
• Athens Radiology Associates PC

  • Diagnostic Radiology Physician
  • Athens, GA
  • NPI 1932189685
  NPD (past)
• Piedmont Rehabilitation Medicine

  • Physical Medicine & Rehabilitation Physician
  • Spartanburg, SC
  • NPI 1386836120
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northeast Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, GA
  • NPI 1427055821
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1236729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1003057621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S ENOTA DR NE STE 360",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013466",
            "telephone_number": "770-219-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-1255",
            "fax_number": "704-446-1276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KIERNEY",
        "middle_name": "ELIZABETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-11",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1397",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7782",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-02288",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0949PA",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003057621",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Dennis Jackson, MD
• James D Jackson, M.D.
• Jeanine M. Jackson, CNNP
• Joseph Loy Jackson, D.M.D.
• Julie Stephens Jackson, AU.D.
• Randy H Jackson, PA
• Rebecca Suzanne Jackson, CNM
• Samuel Joseph Jackson, DMD
• Terence Jackson, M.D.
• Meredith Jackwood, AA

• Physician Assistant in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.